Aktueller denn je – Spiritualität und Religiosität

With his religious ideas Moreno answers to Nietzsches message that god is dead. Mankind pays a high price for disposing of its gods. In his therapeutic philosophy Moreno develops concepts how to draw near to religious themes in a contemporary way. Morenos religious world of images will be introduced in this article. Moreno does not stop with a theory of god. With his axiodrama he develops a methodological frame to enable a lively exchange about individual notions of God. One’s religion is a sphere of high sensitivity. Morenos offer to overcome our speechlessness in this sphere still is up-to-date. (1) Habermas points out that we lose important resources of meaning if we lose our religious language. (2) Within religious contexts bibliodrama and axiodrama are well-known methods. (3) In contexts of commercial enterprise ethical questions become more and more important. (4) Within psychotherapy and counseling spirituality and religiousness are discussed to be important resources. These are good reasons to proceed dealing with Morenos therapeutic philosophy and with his methodological proposals.     

The relationship between epilepsy and religiosity illustrated by the story of the visionary mystic Wise-Knut

The story of Wise-Knut is remarkable. He was born in a poor mountain district in Norway in 1792 and lived for 84 years. He had severe and untreated epilepsy with apparent ictal, postictal, and interictal religious symptoms. He heard voices and had religious delusions; a spiritual awakening after a seizure cluster was a turning point in his life. Contemporary biographers have narrated his major life events in detail, but without a precise separation between ictal and postictal spiritual symptoms. Religious and supernatural significance was attributed to his experiences; he himself believed that his extraordinary abilities were a gift from God: “The prophets have had it like myself.” His story corroborates the impression that epilepsy may have had a considerable role in the history of religions.However, apart from anecdotes on visionary and healing abilities, his biographies contain nothing that is miraculous or incredible. He falls into the line of various mystics and religious figures of the past that are currently thought to have had epilepsy. Apparently, the advancing understanding of epilepsy and its complications have influenced the dynamic balance between faith, superstition, and rationalism.     

On being Moreno’s biographer

This article is about the personal account of Moreno’s biographer. The author shares his experience as he chooses to recapture the life and contribution of the founder of psychodrama, sociodrama and sociometry. He takes us in the intimacy of his journey and the excitement of discoveries through Moreno’s works, archives diggings and numerous encounters with students, disciples and enemies of the author of Who shall survive? The author concludes that entering someone’s else life and works is a magnificent way to get to know ourselves through distanciation and differentiation.     

Moreno und Freud – Späte Einladung zu einer Begegnung

Thinking and practice of Sigmund Freud and Jacob Levi Moreno could inspire and fertilize each other. Still this discussion is mainly ruled by rhetoric of separation. This should be changed. During a fictitious dialogue Freud and Moreno meet each other and talk about all the world and his brother. They talk about their religious background and their philosophy of science, about Morenos roots in the analytic way of thinking and his ideas to develop psychoanalysis. They reason questions like the relationship between divan and stage, the importance of abstinence and the different sources of the unconscious. In the end of the dialogue some ideas are given, how the main instruments of Psychoanalysis—transference, resistance and interpretation—could be used within psychodramatic work.     

The contributions of Kenneth Leslie Artiss, M.D

Kenneth Leslie Artiss (1913-2001) was an Army psychiatrist who did significant investigative work in schizophrenia and milieu therapy and whose broad scholarship led to decisively important and enduring contributions to operational psychiatry. After retirement from military service, he developed a bold approach for teaching psychodynamic theory and its applications, and he led seminars for psychiatry residents and other physicians for over four decades. He was among the first to apply psychodynamic ideas to improve oncology practice. His death in 2001 motivated a group of his military students to memorialize his life and contributions and to demonstrate why they merit continuing consideration.     

Charcot and Babinski: beyond a simple teacher-student relationship

Jean-Martin Charcot (1825-1893) is now considered to be the father of clinical neurology in France. He trained a generation of eminent neurologists, among them Joseph Babinski, with whom he had a special relationship. Babinski was undoubtedly Charcot's favorite pupil and they enjoyed an excellent collaboration at la Salpétrière. Even though both men felt tremendous respect for each other, it is sad that this relationship may, in one instance, have been detrimental to Babinski. This is probably the reason why Bouchard denied him full professorship, a decision with eventual consequences for both men. In spite of this, the neurologist of Polish origin held his master in tremendous admiration, even as he pursued Charcot's research on hysteria after his death. Even though Babinski eventually contradicted his master on many fundamental issues, it did not affect his devotion to him. The relationship between the two men can be considered as more than a simple relationship between a teacher and his pupil and may be compared to a father-son relationship, which is a reminder of the original model of Hippocratic teaching.     

Archaic behavior and the communicative act; the meaning of stretching,yawning, rocking and other fetal behavior in therapy

Résumé A survey has been presented of some fetal responses to stimuli and of how one may find them revived in more differentiated, mature behavior. The fetal response may be looked upon as one of the initial adaptive acts which are automatically transmitted to the unconscious. A person's archaic response provokes intensified communication through mutual identification with the pre-birth situation. As Bolk has explained, man in his biological retardation and fetalization remains dependent on his parents. That is the reason why he sticks to his unconscious identification with his intrauterine existence. It is this common hidden fantasy that makes the communicative element so intensive. Mutual regression leads to the unconscious fantasy of unification and participation. The significance of these phenomena for an elaboration of clinical observation is emphasized.     

Benjamin Franklin, electricity, and the palsies: on the 300th anniversary of his birth

Benjamin Franklin was involved not only with the nature of electricity but with its possible medical utility. He conducted electrical experiments on people with palsies, notably those caused by stroke, to see if electricity from machines could restore movement. Franklin recognized that electricity was not the miraculous cure it was hoped to be, and he presented his findings in 1757 as communication to the Royal Society. Although he did not provide names or individual case studies in this communication, subsequently published in 1758, his personal letters reveal that he treated at least two important colonists: James Logan, William Penn's secretary and a prominent public official in Pennsylvania, and Jonathan Belcher, governor of several provinces. Franklin's private letters shed light on how he conducted his clinical "tryals" and why he drew the conclusions he did in his report to the Royal Society.     

A child is born

As the introduction to his book “Birth Without Violence” states:Why do almost all newborn babies cry bitterly?There is no reason why they should not relax, breathe calmly and enjoy being in the outside world.Perhaps being born is as dramatic and painful for babies as giving birth used to be for mothers.Why does nobody seem to care about the sufferings of babies during birth?These seem the basic problems to pursue, and he has developed a new approach to birth which gives the baby an easy transition from its world to ours.He will show and discuss his new film “Birth” suggesting ways in which we can treat babies as human persons and, with dim lights, quiet and a warm fluid environment, ease them from the womb to the     

Was Hippocrates a beginner at trepanning and where did he learn?

A critical reading of Hippocrates'On Wounds of the Head suggests the writer was a beginner at trepanning. He could not explain clearly, in the pathological terms used in his time, why routine early trepanning was beneficial. His technique was hesitant, suggesting he himself had never done the routine early trepanning he advocated, and he had not yet realised that his policy would be unacceptable to most Greek patients. It is suggested that he might have learnt trepanning on a brief trip to Marseilles, where the Gauls had already trepanned for 1500 years.     

A religious psychiatrist's ethnographic self-report

The religious identity of psychiatric patients is deemed important as it may impact upon the understanding of patients' problems and the quality of the therapeutic relationship. It would seem important that the psychiatrist should also be sensitive to the role of his/her own religious identity and its effect on clinical work. Nevertheless, even in studies by and about psychiatrists who have religious roles within a community, this component has tended to be ignored. A series of self-observations are offered by a religious Jewish psychiatrist to describe the effect of religious identity on himself and his patients during clinical work in Israel. Three types of situations were apparent: when he was unsure about his religious identity, when he was unsure about his professional identity, and when he was dealing with essentially religious rather than psychiatric issues and having to differentiate between his own role and that of a rabbi. These observations support the need to be sensitive to the effect of one's religious identity on clinical work, while appreciating that, as Andrew Sims has stated, the psychiatrist's "attitude towards the patient who shares his faith is as a fellow believer and not as a priest".     

Dante's Divine Comedy revisited: what can modern psychoanalysts learn from a medieval "psychoanalysis"?

I realize after having gone over this material that I have done a sort of deconstruction of Dante's Divine Comedy which putatively attempts to raise the human vision to transcendent heights and to focus love on the love of God, but which along the way indulges in the very human aspects of pity, compassion, music, poetry, and the other arts, as well as reason and puzzlement. In this sense the poem is also an exposition of the value of the higher human faculties, which contrasts at times rather vividly with the apparently harsh autocratic fates that are assigned to some characters--who do not seem quite deserving of what is inflicted upon them. Here we have a collision between absolute faith in the judgment of God and human reason and compassion which sometimes seems to be unable to justify these judgments. In spite of the fact that Dante is trying to adhere to orthodox theology throughout, it is clear that his poetic soul has great difficulty in avoiding the depiction of characters for whom he has a secret sympathy. The central point of this study of The Divine Comedy is to emphasize how Dante, almost in spite of himself, expressed empathy and understanding for a variety of unfortunates either in the Inferno or in the Purgatorio. Virgil even scolds him for his compassion, arguing that God's justice is always correct and if God is angry at someone and punishes him or her, Dante should also be angry and not compassionate. Dante tries, but he cannot quite manage to do it. Translated into modern terminology, we can learn from this report of a medieval "psychoanalysis" an important lesson in our clinical work. Rigid adherence to rules such as those Freud himself proclaimed (although he never followed them), for instance in his famous demand that one be always opaque to the patient, and/or rigid adherence to one or another psychoanalytic theory, must be understood as a form of countertransference, a character flaw in the analyst. Each case demands its own approach and its own form or forms or channels of understanding, just as Dante offers us in The Divine Comedy. It is because he offers such a perspective almost in spite of himself that his poem transcends the medieval mind and becomes relevant to all ages and cultures. As a rule of thumb, when one finds one's instinctual convictions about how to proceed in conflict with one's theories and set of rules, something is wrong. It is with the greatest trepidation that a well-analysed psychoanalyst should force him- or herself to ignore an instinctual or intuitive feeling of how to respond to a patient because it conflicts with some theoretical principles or official rules of procedure. Such a conflict is a call for further self-analysis, consultation with colleagues, and creative solutions.     

Can dementia patients live in a community? A case of a patient in trouble with the law

We experienced a case involving a 67‐year‐old man with Alzheimer's disease who exhibited criminal behaviour. Although his behaviour improved after admission to a long‐term care facility, he was not able to return to his home because he was suspected of theft. At 62 years of age, he developed slowly progressive memory loss and had difficulty managing money. He was diagnosed with Alzheimer's disease and began taking galantamine. He was placed in police custody after he had tried to take another person's fuel tank early one morning. However, he was not charged with theft because he did not remember his actions. Because it was difficult for his sister to constantly monitor him, he was admitted to a long‐term care facility. He displayed high emotional insecurity and continually asked when he could return home. His physical function was good, enabling him to perform various activities alone, but he experienced the delusion of theft during these activities. He appealed the decision prohibiting him from going home. However, the staff suggested that he would exhibit problematic behaviours at home, and it was decided that he should not live at home. After living at the long‐term care facility for 3 years, he died of acute cardiac infarction. When a person goes to jail for committing a crime, that person can return to society after completing a jail term. That was not the case with this man with Alzheimer's disease. As such, guidelines and standards to evaluate the criminal responsibility of dementia patients need to be established.     

The inhibition of action. Interdisciplinary approach of its mechanisms and physiopathology

The author recalls his group's work during the three past decades and how, starting from the study of traumatic states, he established the distinction between shock and stress, physiologically and biologically speaking. According to him, stress supposes a memory process, i.e. the learning of the inefficiency of action in controlling the environmental characteristics. This learning involves cerebral areas and nerve tracks which, as behavioural consequences produce action inhibition. In the neurophysiological field, he underlines the importance, for these mechanisms, of the cortex, dorsal Ammon's horn, lateral tonsil and subthalamic nucleus. He shows why it seems obvious that the mediators of the action inhibiting system are acetylcholine and serotonin. He also recalls the many experimental facts which allow to say that the action inhibiting system is responsible for the release of the hypothalamic-hypophyseal-adrenocortical reaction and of the peripheric sympathetic adrenergic reaction to aggression. He finally shows the function of these two systems where the main pathological accidents originate. He also stresses the discovery and the introduction in the therapeutical paraphernalia of a new molecule minaprine, which he considers as inhibiting action inhibition, and as such, as an indirect anti-depressive drug. The pathology, which is said psychosomatic, thus becomes a pathology of action inhibition, where unconscious memory of past interdictions and failures, relates the subject and his present reaction to environment, to his whole psycho-social past.     

Schizophrenia — a category error

According to conventional psychiatry, the schizophrenic is a ‘patient’ helplessly in the grip of an ‘illness’ that ‘causes’ him to display abnormal social behaviour, much as a patient with diabetes displays abnormal carbohydrate metabolism. In fact, however, schizophrenic behaviour is conduct, not ‘symptom’. Persons called ‘schizophrenic’ do not lack the capacity to make moral decisions: on the contrary, they exaggerate the moral dimensions of ordinary acts, displaying a caricature of decision-making behaviour. “The last thing that can be said of a lunatic”, writes Gilbert K. Chesterton, “is that his actions are causeless. If any human acts may loosely be called causeless, they are the minor acts of a healthy man; whistling as he walks; slashing the grass with a stick; kicking his heels or rubbing his hands.” Chesterton² then delivers this stunning aphorism about madness: “The madman is not the man who has lost his reason. The madman is the man who has lost everything except his reason.”I agree. I believe that whatever small truth might lurk in the biological and psychological ‘explanations’ of schizophrenia, such accounts are largely false- for the same reason that the schizophrenic's ‘delusive’ explanations of the world about him are false: both accounts serve to disguise certain unbearably painful truths about human existence. In my opinion⁸, being schizophrenic (in the sense of schizophrenia as mental disease) is a career, just as being a psychiatrist is a career. We are now prevented from seeing this because officially ‘schizophrenia’ is the name of a psychosis and ‘psychiatry’ is the name of a profession. But names are only labels. Conventional psychiatry refuses to scrutinize schizophrenia as a name and insists that because it is the name of a disease, the thing it names is a disease. That reasoning is not worthy of further criticism.Except when used in the highly restricted sense of a name for an as yet undiscovered brain disease, schizophrenia is not a medical but a moral problem. Bleuler's great predecessor, that famous physician of the soul, has warned: “For what shall it profit a man, if he shall gain the whole world, and lose his own soul?” Jesus understood that the man who loses his soul loses everything — except his reason! That is why the poets used to call madmen “lost souls” or the “living dead”. Accordingly, such persons need spiritual regeneration (or generation) — something that theologians no longer respect and therapists refuse to recognize.The void between the spiritual and material realms has plagued mankind for millennia. In the past, men tried to fill that void with theological fables. Today they try to fill it with therapeutic fables. Among these fables, the theories and treatments of schizophrenia are among the most popular.     

Tele aus neurobiologischer Sicht

This article from the journal “Zeitschrift für Psychodrama und Soziometrie” discusses Moreno’s tele concept against the background of neurobiological research. Moreno’s idea of man and his philosophy of life is inseparably connected with the concept of mutual relatedness insofar that he even regarded tele as biologically founded. As current neurobiological research seems to support this assumption, Morenos tele concept may be seen as a visionary pioneer work for understanding the function of psychotherapy as well as a challenge for an expanded perception of tele.     

Significance of the affinity of the epileptic to somatesthetic religion

A case in which a close relation was observed between epilepsy and a form of religious faith is discussed. This patient had a distinct inclination towards a religion which put more emphasis on the body than the mind. In addition, he found a specifically religious significance in the so-called 'aura' of his epileptic seizure, and this was an important point which linked him to the religious organization he belonged to. The author considered that the inclination to a religion which put emphasis on the body was important in discussing the religious psychopathology of the epileptic patient.     

Die Grundlagen der Soziometrie �C fr��her und heute

Sociometry as a method of social reseach is used to analyze interpersonal relations in small groups (cold sociometry) and as a base to rearrange group composition according the informal relationships (hot sociometry). These two ideas are promoted by the psychiatrist Jacob Levy Moreno (Who shall survive? 1934). A thorough look at the history of social research instruments shows, that he doesn??t invent the analyzing sociometric method as the first author. But his new and creative idea was the second idea: the rearrangement of group composition according to sociometric choices. He proposed this method not only as a therapeutic and organizational tool, but as a political sociometric movement, the so called ??hot?? sociometry. The cold sociometry is actually as ??network analysis?? expanding and of growing interest in many disciplines??the hot sociometry remains a organizational, therapeutic idea, which failed as political idea.     

Consideration of the concepts of "remission" and "cured" in schizophrenia: a male case who experienced schizophrenia with psycho-motoric excitation 30 years ago]

Since the era of Kraepelin and Bleuler, schizophrenia has been considered to be very difficult to cure. Even if all symptoms of its acute phase have disappeared completely, it is customary to use the terms say "remission" instead of "cured". The chief reason why they have been unwilling to say "cured" is that, even if the present state seems to be "cured", there will be surely another attack in near future, so, the non-symptomatic state should not be understood as "cured". Whether schizophrenic patients can be cured or not is one of the great problems of modern psychiatry. Is there no probability for them to be cured? Recently, after a 30 years gap, I came to meet a man who had had a schizophrenic attack of the psychomotoric type when he was 25 years old and had been sent to the mental hospital where I had been at work and, by chance, had engaged in his treatment. After about 5 months' of acute state, he came at, so to speak, "Residualzustand" (Conrad) for about 1 year and then got insight into his psychosis. After the discharge, he had visited me as an outpatient once a month regularly. About one year thereafter, the change of my work place made us separate from each other. Since then, he stopped visiting the doctor and also stopped taking anti-psychotic drugs. He married at 29 years old and had 2 daughters and a son. In addition, he had started to work for his father's business. After his father's death, he became the owner of 5 shops and the supervisor of 50 workers. Is he not yet "cured"? Is he only in the state of "remission" even now? According to the principle of Kraepelin and Bleuler, he is not "cured" yet, because he will surely have a psychotic exacerbation in future. I wonder then, what is the difference of the two concepts of "remission" and "cured", and how is it possible to change "remission" to "cured"? Even Bleuler, E. has written in his world-famous textbook that the longer the duration of remission after the last attack, the smaller the probability of the next attack, and that after about 5 years free of attack, another exacerbation would be very improbable. Supported by the experiences of Utena, Miya and so forth, I proposed a thesis that if a person who had undergone schizophrenic attack has been in complete remission for more than 10 years, he can surely be counted as "cured". To verify this probability about the outcome of schizophrenia, it is very important for us to observe any patient who has attained the state of complete remission, and to describe and report his state thereafter as long enough as